颈静脉孔区解剖培训课件
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#应用解剖#颈静脉孔的应用解剖学肖 明, 丁 炯, 韩群颖, 王鹤鸣, 左国平(南京医科大学解剖学教研室,江苏南京210029) =摘要>目的:为与颈静脉孔相关的影像诊断和临床治疗提供解剖学资料。
方法:从颅底内、外面,对80具成年颅骨的颈静脉孔进行观测;并对20具成人尸头进行解剖,观察该区域神经血管解剖关系。
结果:¹62.3%右侧颈静脉孔较左侧大,15.9%左侧较大,21.8%两侧大小一致;º14.38%的颈静脉孔有骨桥,85.62%无骨桥;»颈静脉孔内、外侧缘距正中矢状面两侧的平均距离颅外均较颅内大:颅外分别为26.11mm 和33.41mm,颅内分别为22.29mm 和27.52mm 。
¼Ù脑神经多沿颈静脉孔前上缘,Ú、Û脑神经沿内侧缘出颅,两者被纤维索(占87.5%)或骨桥(占12.5%)隔开。
½Ù脑神经多经颈静脉孔外口前上缘向前下越过颈内动脉表面;Ù脑神经经颈内静脉深面(占57.5%)或其浅面(42.5%)行向后下。
结论:右侧颈静脉孔通常较左侧大,左右不对称;影像学观测该区域血管、神经应选择恰当的层面。
=关键词>颈静脉孔; 颈内静脉; 脑神经; 应用解剖学=中图分类号>R323.1 =文献标识码>A =文章编号>1001-165X(2001)02-0159-03Applied anatomy of jugular foramen XIAO Ming,DING J ong ,HAN Qun -ying,et al.De p a rtment o f A natom y ,Nan j ing Medical University ,Nan j ing 210029,China=Abstract >Objective:To provide anatomic data for imaging diagnosis and microsurgical treatment of jugular fora -men (JF)lesions.Methods:The JF was observed and measured from internal and external aspects in 80adult skulls.The anatomic relationships between the nerves and vessles in this region were observed i n detail by dissecting 20adult cephalic specimens.Results:¹In 62.3%of all these cases the right JF was larger than the left.In 15.9%the left was larger and in 21.8%they were equal in size.ºBone bridges could be seen in 14.38%and could not in 85.62%.»Measured from extracranial aspect,the average distance from midsagi ttal plane to the medial and lateral border of the JF (medial 26.11mm,lateral 33.41mm),was larger than those measured from intracramial aspect (medial 22.29mm,lat -eral 27.52mm).¼Ùcranial nerve made its ex i t through the anterior superior border of the JF in most cases,meanwhile Úand Ûcranial nerve through the medial border,they were distinctly separated from each other by a band of fibrous tissue (account for 87.5%)or a bone bridge (12.5%).½Jus t outside the J F,Ùcranial nerve appeared at the anter-ior border and made a loop downward and forward superficial to the internal carotid artery.Ùcranial nerve run down ward and back ward deep (account for 57.5%),or superficially (42.5%)to the internal jugular vei n.Conclusions:T he right J F is usually larger than the left,and not symmetry on both sides.The key to imaging diagnosi s of nerves and ves -sels in the JF region is to select the sectional plane correctly.=Key w ords >Jugular foramen; Internal jugular vein; Cranial nerve; Applied anatomy颈静脉孔为枕骨与颞骨岩部之间的一骨性孔道,位于岩枕缝的后端,被颈内静脉结节分为二部或三部[1]。
颈静脉孔区解剖
HELLO NOVEMBER
颈静脉孔由枕骨基底部和颞骨岩部下面围成,近似呈尖向前内的三角形,内侧壁为枕骨基底部,后外侧壁为颈静脉窝,前外侧壁为颈静脉内突和颈动脉管内侧壁。
内主要有岩下窦、颅神经及乙状窦等重要结构。
Hovelague将颈静脉孔分为两部分:前内侧部较小,内含有舌咽神经,也叫作神经部;后外侧部较大,内含有颈静脉球体、迷走神经和副神经,叫作静脉部。
这两部分通常被纤维桥或骨桥分隔。
在颈静脉孔上覆盖有硬脑膜,在硬脑膜上有两个孔洞,一个孔为舌咽神经经过的通路,此神经经孔进入神经部;另一个是迷走神经孔,迷走神经和副神经由此孔进入静脉部。
上述诸结构在颈静脉孔内的位置与相互毗邻关系, 国内外有关文献描术不一。
岩下窦在颈静脉孔注入颈内静脉。
舌咽神经、迷走神经及副神经经颈静脉孔出颅。
乙状窦经颈静脉孔延续为颈内静脉。